Monthly Archives: May 2013

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The AOA and AMA constantly call for replacement of the SGR, which would be helpful. But, the AOA and AMA never says what they’d like it replaced with. It has been my impression that they would except ANY hair-brained far-fetched government scheme for payment.

Instead the AOA and AMA must lobby and push for removal of prohibition of balance billing. This woul allow physicians to bill patients for cost overruns. Medicine is the only profession or industry that is not permitted by contract or law to bill freely. Further, they should suggest that Medicare pay a percentage of what the physician billed, so that DOs and MDs can compete against each other on price. It is only in that way that a fair competitive efficient market value will be determined, not SGR, not reasonable and customary, and not pay for performance nonsense.

There has not been a true freemarket in medicine since prior to the establishment of Medicare in 1960. It’s about time that all “stakeholders,” or as I call them, “strangleholders,” (government, hospitals, ACOs, healthinsurance companies, big pharma, etc.) were forced out of the drivers seat to allow patients to drive in the healthcare healthfreedom freemarket. After all, healthcare is entirely about the patient.

Unintended consequences means a behavior or circumstance determines the outcome with different results than intended. The US people have spoken. They are envious of the promise of socialized healthcare as is promoted in other countries like Canada. Americans’ fantasy of Canadian style, “healthcare for all,” is, in actuality, a two tiered system. One tier is the government owned and run system with all its delays, costs and access issues. The other tier is the direct patient pay system for people who want their care now and are willing to pay for it(except where it is outlawed or otherwise unavailable.) Any medical service covered under the provincial health insurance plan cannot be purchased privately on Canadian soil. The only other option for Canadians is to come over the border to the US and pay directly for their procedures here; which they do frequently.

The people elected a congress and a president who made this their goal. The “stakeholders” were at the table with lobbying money and powerful political favors. These groups included the politicians in Washington, DC, American Hospital Association(AHA), pharmaceutical industry(PhRMA), Health Insurance Industry, big business, American Medical Association(AMA), information technology industry (HIT), American Association of Retired Persons(AARP), union leaders, and others. Notably missing were practicing physicians and actual patients. Each powerful entity got their paid politicians to write their own part to get their “buy in” figuratively and literally. Congressed passed the legislation, in the dark of night, without everyone reading the whole 2,800 page law. Remember congresswoman Nancy Pelosi selling it to America saying, “But we have to pass the [health care] bill so that you can find out what is in it.”

The intended consequence that America thought they wanted was a socialized government taxpayer sponsored health insurance safety net for all citizens. What America got was the Patient Protection and Affordable Care Act(PPACA), or “Obamacare.” Instead of the government owning and operating the healthcare system, as in Canada, it is sold out to private corporate interests but ruled by government law, as in fascism. Hospital owned accountable care organizations(ACO) will dominate the landscape. The government intends this broad stroke will save everyone money by increasing layers of healthcare administration 100 fold. Even the supreme court violated the consitution by enforcing that each citizen be mandated to buy a health insurance policy that must conform to government specs. Congress exempted themselves and their cronies from Obamacare and they kept their “Cadillac” health plan that taxpayers pay for. Government uses taxpayer funding for Medicare and Medicaid. Now they are subsidizing federally qualified healthcare centers to accept government plans as private competitive practices can’t afford to accept them.

The unintended consequences of PPACA/Obamacare are now becoming evident. The program costs will be much higher than expected and are unfunded, having no base in US economic reality. It increases the price of each insurance policy. Every citizen must buy an approved policy from an appoved vendor or be penalized with a “tax.” Less citizens will be insured due to increased policy costs and administration. They will just pay or ignore the IRS tax penalty as it is cheaper than a $20,000+ government approved insurance plan. Care will be rendered by huge hospital centric ACOs that know nothing about efficiency, economy, cost-savings or the practice of personal Hippocratic medicine. Hospital ACOs are investing millions each in development in hopes of “shared savings,” from Medicare, Medicaid and private health insurance plans. Government organization history clearly shows that these savings bonuses will never materialize. Medicaid ghettos are forming where only government supported federally qualified health centers can fiscally survive.

A Canadian style two-tiered system is forming and so, similar access issues, cost issues and care delays. One day soon US citizens may elect to cross the border and pay for their surgeries and treatments in Mexico. Americans, too, will be forced to chose between government promises of taxpayer funded hospital ACO impersonal healthcare, or the ever-present direct patient pay model since the beginning of recorded time. When will the government learn to first do a small scale experiment of a concept before committing unending streams of taxpayer and borrowed dollars?

Now is the time for physicians to regain the control of the health care system, loosen the chains of the malpractice system and regain the trust of the public– the well-earned trust.

There is a law being proposed in New Jersey that could spread nationwide once passed. Essentially we are asking for the State to provide medical malpractice protection in the PRIVATE practices of physicians who DONATE a significant amount of free care to the poor, uninsured and undocumented in or through non-government free clinics. This will apply to any physician who donates an average of four hours a week– including surgeons and OB-GYNs. It will be a win-win-win for the patients, physicians and taxpayers, as we all know the Medicaid system is wildly expensive and provides poor compensation to the physicians and poor access to the patients.

I call this “stealth med-mal reform.” We are anticipating that it will be discussed in the NJ Senate Health Committee on June 13th– if all goes well.

The following website is a collection of short speeches by:
Nora Craig, a citizen activist who champions community involvement.
Ralph Weber, a Canadian ex-patriot health care expert, moderator.
Alieta Eck, MD, co-founder of the Zarephath Health Center, who explains the NJ S-2231 legislation.
Murray Sabrin, finance professor who explains why government health care costs too much.
Jeff Liegner, MD, opthalmologist, founder of the free clinic in Newton, NJ.
Donna Rovito, citizen activist in Pennsylvania, talking about medical malpractice.
If you have some time during the holiday weekend, you might want to listen in. This was the AAPS conference we held a year ago in Somerset, NJ, sponsored by the Association of American Physicians and Surgeons (AAPS). We will post any developments on the http://www.NJAAPS.org website.http://www.songtoday.com/GAPnzhwwYB8_true-charity-vs-government-handouts-creating-volunteer-medical-clinics.html
Alieta Eck, MD
Co-founder, Zarephath Health Center
Immediate Past-President, AAPS
Physician in private practice, Internal Medicine, Piscataway, NJ

Thank you All for your tenacity! This is the future of Osteopathy. Read John Lewis’s biography of ATStill. The battles state and federal to get osteopathy were HUGE. These battles were from without the profession. Now the battles are from within our profession! The word needs to get out to all DO’s and the response to the AOA needs to be clear, decisive, and massive.

A mighty hoorah to Drs. Smutny, Eck, Watson, and Wax and all for your comments…. and for your
communications with the AOA and AMA leadership. We need more of this.

I hope you get some responses. AOA leaders generally do not respond to most Emails if
they are critical or corrective of AOA Policies and Mandates.

Most private practice physicians are generally opposed to AOA’s promotion of MOL, MOC, OCC, ACA, COMLEX, Needs Assessment, EHR, and other acronym mandates. Instead of punishing its members with all of these mandates, AOA and AMA should be protecting our physicians from the long arm of government and insurance company intervention.

I personally felt it was a definite embarrassment for our profession with Dr. Levine’s promotion of MOC, MOL, and OCC two weeks ago at the University of Pennsylvania Medical School meeting.

Physicians across the company are outraged. However, their typical apathy prevents them from
letting that outrage be known. We need a national campaign to inform physicians across the
country of these mandates being proposed…. and a method of inducing them to contact their
county, state, and national leaders along with their specialty societies and let their opinions
be known to the leadership.

Many of us assume, that by your e-mail, you are in fact one of the primary sources. If not, please feel free to e-mail us the correct primary sources so that we may take this to that level.

Please feel free to supply ALL the data, ALL the votes, ALL the answers you have circulated, the possible resolutions offered by members of the profession and the entire process that you used to arrive at your conclusions.

If you are to represent the entire profession you must interact with the entire profession and document it clearly. You must also make that information available to those you would represent.

You can “reply all” if you think that will ease the process.

Your assumption that we do not attempt to address the primary sources is in grave error. Please check your personal and AOA e-mail and the respective spam boxes therein for verification of our contacting you directly and the cc on each that has gone to other Leaders in our profession.

Martin, I received my notice today from the American Osteopathic Board of Preventive Medicine informing me about OCC being displayed on each physician’s official profile report.

Since I have a non-time-limited certificate, I am not required to participate in the OCC process—and won’t. Will you, Martin?
And I sure won’t send $400 by credit card or check “to activate your participation in the OCC process.”

AOA has colluded with FSMB in nothing more than a money making scheme. The anti-trust implications are huge. For me to tell you that you would not get the CME appropriate for your practice is just as ridiculous as you telling us that OCC is the only way that we will continue to be good doctors for our patients wants and needs—getting the CME that is appropriate for our practices—not the politically correct excrement that the AOA accredits as CME.

Doctors were respected back in the days when we accepted cash, firewood, chickens—and took care of the poor out of the goodness of our hearts. Charity belongs at the local level. Why have good organizations like the AOA allowed government to take over our profession? Why were you not fighting back against Obamacare?
Shame on YOU!

I would love to have a conversation on getting our profession back, but fear that bureaucracy is all that the leadership of AOA knows. I have a cash practice and I provide charity, and I love what I do. That is what every DO should be able to say.

Best regards,

George R Watson, DO
Member, AAPS—the only organization that represents physicians.